Informed Consent Parenting

A friend of mine and I were talking this evening about our kids. She is a fellow physician with a similar situation: she and her husband are gifted and highly educated, and they have four gifted kids, all elementary-school age. We like to meet frequently and hash over the parenting and educational decisions we’re struggling to make. We met at the park (where predictably, none of them played on the actual playground), ate some dessert she so thoughtfully brought, and watched the kids expend significant amounts of energy as the sun set over the mountains and the lake. It was a great way to end the evening.

One of the topics we visit frequently is whether or not we are making the “right” decisions for our gifted kids. By way of explanation, these would be the decisions that are the best fit for each individual, and eventually result in them leading happy lives with deep personal significance. No pressure there.

The usual parenting mantra explains that we shouldn’t take any of these decisions too seriously, because we can always choose to change the path we’re on, and kids are resilient creatures. Land the helicopter, moms, the kids will be just fine without you.

Interestingly, though, she and I are two of the more laid-back moms we know. I’ve never figured out if this is because we’re both physicians, but we aren’t really the hovering type. We let the kids wander further than most folks, and trust that they’ll make good decisions, because they usually do. And, when they don’t, it’s not the end of the world. We both expect our kids to take personal responsibility for themselves and the things around them. In general, the seven of them are incredibly well-behaved when they are together. They also have several casts and sets of stitches between them.

So why, then, do we mull over the educational decisions so much? Why not just let them roam and trust that they will find their way?

The only reasoning I can give for our behavior is a medical analogy. She and I encounter many issues throughout our day that are low-risk: simple skin tears requiring basic skin care, gout in a knee that will respond well to some medication, or a mild sleep disorder treatable with lifestyle changes. A quick explanation to our patient on the condition, followed by reassurances that the condition will likely be better in a few days or weeks. And, if it’s not, there are always opportunities to go back and change the treatment plan. Not much deep thought into the decisions, because the stakes aren’t that high. Just listening to our patient is often what they need the most in these cases.

We also encounter, albeit less frequently, issues that are high-risk: the chest pain as a first sign of a heart attack, the shortness of breath from a new blood clot in the lung, or the discovery of a cancer that requires chemotherapy to eradicate. And, for each of these decisions, there’s a point of no return. The point where we have to explain to the patient what the next steps are going to be, offer our support through the process, and guide the process so that everything goes smoothly for our patient. We recruit our specialist colleagues for their expertise. We research different options and present these to our patient and their families. We make sure we’ve explained it enough times, and with enough detail, that our patient understands the implications. In short, once the decision is made, it’s made. And there’s (usually) no going back. No second chances to get it right.

I’ve decided that the hardest part for us, the two physicians, is that when it comes to our kids, we’re not sure which bucket our educational decisions fall into. We have no way of knowing whether there’s time or opportunity to go back and redo it, or change our path. It feels as though some of the decisions might be the high-risk type, the ones where we don’t get a second chance to get it right. What if we present the options to our kids, and we all make the wrong decision together? What if we can’t change it later, and we somehow missed the opportunity to help them be truly happy? It’s hard enough for she and I to live with a missed diagnosis in our patient. It’s almost impossible for us to live with a missed decision in our own child.

I’m eternally grateful, then, for the opportunity to bend the ear of my friend and fellow physician-mom-of-gifted-kids every chance we get. It makes the burden of the decisions lighter, even if their weight is unchanged.